Malaria
Malaria is transmitted by the female mosquito, there are roughly 30-50 species of mosquito that have been found to transmit malaria. The disease malaria is caused by a type of parasite called plasmodium. Four different types of plasmodium cause malaria, but in different severities.
Malaria is present in Asia, Sub-Saharan Africa, Central and South America, the Caribbean, the Middle East and parts of Eastern Europe. Temperature and rainfall are major roles in the life cycle of the mosquito and therefore important in the incidence of malaria.
Preventative Measures (non-drug)
- Use insect repellent containing DEET.
- Wear long sleeves and pants especially at dusk and dawn when mosquitos are most active.
- Avoid wearing dark colors
- Avoid wearing scented things such as perfume, cologne and cometics
- Use mosquito netting When sleeping.
Preventative Measures (drug)
Malarone™ (Atovaquone/proguanil combination)
is taken once daily, starting 1-2 days prior to travel, continued for the duration of the travel time and ending 7 days after leaving the malarial area.
- Side effects include stomach pain, nausea, vomiting, and headache. Vivid dreams have also been associated with Malarone but subside once the drug is discontinued. People suffering from decreased renal function, children under 5kg, women nursing children under 5kg, pregnant women and those allergic to either drug should not take Malarone™. Malarone™ is expensive when compared to other anti-malarial medications.
Aralen™ (Chloroquine phosphate)
is taken once a week, starting 2 weeks prior to travel, continued for the duration of the travel in malaria area ending 4 weeks after leaving the malaria area. The medication should be taken on the same day every week.
used in Mexico, Central America, the Middle East and Eastern Europe. It is not recommended for use in South America or Sub-Saharan Africa as Chloroquine-resistant malaria has been found in these areas. Chroloquine has long-term use inforamtion available.
Side effects include nausea, vomiting, headache, dizziness, blurred vision and itching. Chloroquine may increase the symptoms in those suffering from psoriasis, and should not be taken by people who are allergic. Chloroquine is inexpensive when compared to other medications.
Plaquenil™ (Hydroxychloroquine sulfate)
- is taken once weekly, starting 2 weeks before traveling, continued while traveling in malaria area and ending 4 weeks after leaving the malaria area. The medication should be taken on the same day every week.
- Side effects include nausea, vomiting, headache, dizziness, sleepiness, blurred vision and itching.
Lariam™ (Mefloquine)
is taken once weekly 2 weeks prior to travel, continued for the duration of the travel time and ending 4 weeks after leaving the malaria area. The medication should be taken on the same day every week.
*side effects include nausea, headache, dizziness, sleep difficulty, impaired vision, anxiety, vivid dreams, seizures, depression and psycho-neurological problems. Due to the slower elimination time (from the body), side effects may continue for weeks or months after discontinuation of treatment. It has been reported that women experience more severe side effects than men. People suffering from or who have a recent history of depression should not take this medication. Those with a history of psychosis, anxiety, schizophrenia, seizures, cardiac abnormalities (such as irregular heartbeat) or are allergic should also refrain from taking Lariam™.
Doxycycline
is taken once daily, starting 1-2 days prior to travel, continued for the duration of the travel time and ending 4 weeks after leaving the malaria area
can be used as an anti-malarial in all areas
Side effects include sun sensitivity, nausea, stomach pain. Take this medication at least one hour before bedtime to avoid reflux into the esphagus (heartburn). Some women may develop vaginal yeast infections with long-term use. Women taking oral contraceptives (OC) are advised to use additional forms of birth control (condoms, diaphragms, etc.) while also taking Doxycycline as this medication can decrease the effectiveness of the OCs. Pregnant women, children under age 8 and those allergic to tetracycline compounds should not take this medication.
Symptoms
flu-like symptoms which can include fever, shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur.
Malaria symptoms will occur at least six to nine days after being bitten by an infected mosquito. Therefore, fever in the first week of travel in a malaria-risk area is unlikely to be malaria;
